A low-cost, high-resolution, high-contrast color digital camera optimized for ophthalmology will be demonstrated. This Optimized Retinal Camera will be specifically tested for its effectiveness in meeting the image quality requirements for the screening and assessment of pre-proliferative and proliferative diabetic retinopathy in both traditional clinical settings and in telemedicine. The proposed device exploits recent technological advances in high sensitivity charge coupled device (CCD) cameras and digital signal processing electronics. Today's CCD cameras do not have the dynamic range to image the human retina. The human retina is characterized by regions of high reflectivity (20-40 percent), such as the optic disc, and very low reflectivity (<2 percent), such as the macula and fovea. Further, these existing digital cameras treat each of the color channels in the same manner and do not consider the special, red-saturated characteristics of the retina. The approach builds on existing fundus imaging technology developed by Kestrel for the National Eye Institute. The proposed Optimized Retinal Camera will be shown to offer significant improvement over existing digital color cameras by addressing each of the deficiencies mentioned above. Joslin Diabetes Center, the University of Iowa Department of Opthalmology, and the University of New Mexico Health Sciences Center will provide independent, "masked" evaluation of the optimized digital retinal images.